Hopper Ingrid, Kotecha Dipak, Chin Ken Lee, Mentz Robert J, von Lueder Thomas G
Monash Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia.
Clinical Pharmacology Department, Alfred Health, Melbourne, Australia.
Curr Heart Fail Rep. 2016 Feb;13(1):1-12. doi: 10.1007/s11897-016-0280-1.
Compared to men, women with heart failure (HF) are often older, smoke less, and have more preserved ejection fraction (EF) and hypertensive HF rather than HF of ischemic etiology. Gender-stratified outcomes on comorbidities data in HF are scarce. Women have traditionally been underrepresented in HF trials. Although data suggest that overall prognosis may be better in women, they experience lower quality of life with greater functional impairment from HF compared to men. Gender differences have been reported for comorbid diabetes, chronic obstructive pulmonary disease, renal dysfunction, anemia, and depression and may explain gender disparity in outcomes. However, possible confounding of comorbidities with known prognostic determinants in HF (such as EF) as well as gender differences in the utilization of medical therapies obscures interpretation. In this review, we will explore the evidence for gender differences in non-cardiovascular comorbidities in HF. Our findings may guide clinicians to individualize HF care, according to best practice, in the hope of improving prognosis for this chronic and debilitating condition.
与男性相比，心力衰竭（HF）女性患者通常年龄更大、吸烟更少，射血分数（EF）保留更多，且患高血压性心力衰竭而非缺血性病因心力衰竭的比例更高。关于心力衰竭合并症数据的性别分层结果很少见。传统上，女性在心力衰竭试验中的代表性不足。尽管数据表明女性的总体预后可能更好，但与男性相比，她们因心力衰竭导致的功能损害更大，生活质量更低。已有报道称，合并糖尿病、慢性阻塞性肺疾病、肾功能不全、贫血和抑郁症存在性别差异，这可能解释了预后方面的性别差异。然而，合并症与心力衰竭已知预后决定因素（如EF）之间可能存在的混杂因素，以及药物治疗使用方面的性别差异，使得解释变得模糊不清。在本综述中，我们将探讨心力衰竭中非心血管合并症性别差异的证据。我们的研究结果可能会指导临床医生根据最佳实践对心力衰竭护理进行个体化，以期改善这种慢性衰弱性疾病的预后。
